$Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures$
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Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures

IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates an...

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Bibliographic Details
Published in:	BMJ open Vol. 11; no. 10; p. e052966
Main Authors:	Mendes Jr, Adriano Fernando, Curado, Rodrigo Fleury, Dias Jr, Jair Moreira, Mota Neto, José Da, Carrazzone, Oreste Lemos, Pagan, Alexandre Rosa, Labronici, Pedro José, Labronici, Gustavo José, Goes, Matheus Pires De Araújo, Mouraria, Guilherme Grisi, Zogbi, Daniel Romano, Brigatto, Rafael Mulatti, Uehara, Anderson, Parro, Otávio Costa, Hisano, Fernando Mitsuo, Teixeira, Bruno De Souza, Silva, Rafael Waldolato, Lazarini, Rafael Fuchs, Godinho, André Couto, Godinho, Pedro Couto, França, Flavio De Oliveira, Godinho, Glaydson Gomes, Freitas, José Marcio Alves, Mariosa, Carlos Alberto Menezes, Souza, Bruno Gonçalves Schröder e, De Oliveira, Valdeci Manoel, De Simoni, Leandro Furtado, Pereira, Camila Corrêa, Antunes Filho, Jurandir, Matsunaga, Fabio Teruo, Belloti, João Carlos, Tamaoki, Marcel Jun Sugawara
Format:	Journal Article
Language:	English
Published:	London British Medical Journal Publishing Group 29-10-2021 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Protocol
Subjects:	Clinical trials Elbow elbow & shoulder Fractures Hospitals orthopaedic & trauma surgery Orthopedics Patient satisfaction Shoulder Surgery Transplants & implants Trauma trauma management
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Summary:	IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.Methods and analysisThe study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.Ethics and disseminationStudy approved by the institutional ethics committee (number 34249120.9.0000.5505—V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.Trial registration numberRBR-3czz68)/UTN U1111-1257-8953.
Bibliography:	Protocol ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2021-052966